Intrauterine administration

Diaz-Flores, M., G. Duran-Reyes, and J.J. Hicks. 1994. Arrest of rat embryonic development by the inhibition of gamma-glutamyl transpeptidase. I. Intrauterine administration of L-serine-borate complex. Int J Fertil Menopausal Stud 39 234. 

These drugs are available as sodium salts. In general, they are expensive and their use in equine practice is limited. A veterinary approved formulation of ticarcillin is available in the USA for intrauterine administration to mares. 

Table 11.2 Recommended doses for intrauterine administration of antimycotic agents for the therapy of uterine fungal Infections In mares...

Drill [77] has pointed out that the ability to support pregnancy correlates with a positive result in the McGinty assay (p. 184) involving intrauterine administration of the steroid. Likewise, inactive steroids are inactive in this assay. 

The intrauterine administration of progesterone, contained in a silastic capsule attached directly to a Lippes loop (see Figure 5.6) and introduced into the uterus in the usual way, Im recently been reported by Scommegna,... 

The Mirena system for intrauterine administration of levonorgestrel is estimated to release some 20 micrograms of the drug daily. This has been the subject of some sharply differing assessments. In a mailed questionnaire study of 1056 British women who had been treated with this product for menstrual disorders, 73% had continued using the system, having found that it provided relief the most common adverse effect was menstrual spotting (19%) [73 ]. 

Many technicians may not be famihar with terms such as sublingual (under the tongue), buccal (between the cheek and gingiva), otic, and so on. A clear description of each of these nontraditional routes (i.e., other than gavage routes) should be discussed with technicians, and instructions may also be written down and given to them. Demonstrations are often useftd to illustrate selected techniques of administration (e.g., to use an inhaler or nebulizer). Some chemicals must be placed by technicians into body orifices (e.g., medicated intrauterine devices such as Proges-terset). 

Small doses of progestins administered orally or by implantation under the skin can be used for contraception. They are particularly suited for use in patients for whom estrogen administration is undesirable. They are about as effective as intrauterine devices or combination pills containing 20-30 meg of ethinyl estradiol. There is a high incidence of abnormal bleeding. 

Other less frequently used parenteral routes such as intra-articular or sub-conjuctival injections and intramammary or intrauterine infusions have limited application they aim at directly placing high drug concentrations close to the site of infection. These routes of administration differ from the major parenteral routes in that absorption into the systemic circulation is not a prerequisite for delivery of drug to the site of action. When the infection site is relatively inaccessible, such as in the case of mastitis, the combined use of systemic and local delivery of drug to the site of infection may represent the optimum approach to treatment. 

Dicloxacillin is absorbed well from the gastrointestinal tract but the presence of food in the stomach reduces resorption. Although cloxacillin differs chemically from oxacillin only in the presence of a chlorine atom, their absorption profile after oral administration is not similar. Cloxacillin is more rapidly and effectively absorbed than oxacillin. However, absorption of all isoxazolyl penicillins is better when given by intramuscular injection. These agents can be also administered by intravenous, intrauterine, intra-articular, intrapleural, and intramammary injections. 

Rifaximin possesses a broad spectrum of action against both gram-positive and gram-negative bacteria. In veterinary medicine, it is intended for administration by intramammary and intrauterine route in cattle, for treatment and prevention of mastitis during the dry period (100 mg rifaximin per quarter), and for treatment of postpartum metritis (50-200 mg per animal), respectively. It is also intended for topical use in cattle, sheep, goats, and rabbits for treatment of foot and skin bacterial diseases (0.34-2.44 mg/kg bw/day for 5-10 days). 

Intrauterine infusion (intra-amniotic or extra-amniotic) has been reported to be associated with fewer gastrointestinal symptoms and less fever than parenteral or intra-vaginal administration (122). In intra-amniotic use, the puncture must be guided by ultrasonography, and before injection a control aspiration of some amnio tic fluid is required in order to avoid intrauterine or intravascular injection. Uterine rupture has been described with intra-amniotic treatment. 

Intramuscular injection of carboprost tromethamine can also be used to induce abortion. Unlike the one-time intrauterine instillation of dinoprost, carboprost is given repeatedly up to the total dose of 2.6 mg normally required to cause abortion. Intra-amniotic administration has close to a 100% success rate, with fewer and less severe adverse effects than intravenous administration. 

Several types of CDD systems have been designed based on various mechanisms of drug release (Table I). These mechanisms are dependent on the required site of drug delivery, the physicochemical properties of the drug and also of the delivery vehicle (13), Modes of administration can be oral, sublingual, transdermal, rectal, intrauterine, ocular, or parenteral (intramuscular, peritoneal, and subcutaneous routes of injection). 

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